Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 212218 | NY |
NPI | 1285854281 |
---|---|
Provider Name | Jonathan D Goldstein |
First Address | Jericho, NY 11753 |
Second Address | Mineola, NY 11501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 13/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A100001743 | (02) | NY |
A400014948 | (02) | NY |